Yes, Google is a Monopoly and Therapists Have To Work With the Monarch

Have no doubt, Google is a monopoly. No matter how hard they try therapists and counselors and private practices can’t escape Google if they want to attract potential clients online. But this reality has disheartened many therapists.

Google’s original motto was “Don’t be evil,” but since the pandemic many private practices have come to believe that Google is a necessary evil. One that causes more harm than good. As illustrated in a Bloomberg article from August, 2020, some therapists feel that they can’t compete for Ad space against the hundreds of millions of dollars tossed around by companies like Betterhelp and Psychology Today.

They’re not wrong. It can be disheartening.

But the article has tunnel vision about Google Ads. It fails to recognize that the only way to make Google Ads effective is through a multipart strategy. That means a strategy that loops in a website and a proper Google My Business (GMB) listing.

What the Bloomberg article fails to recognize is that Google Ads doesn’t exist in a vacuum.

An image of the board game Monopoly's play pieces, including money and game pieces.

Google Ads and Therapists

The pandemic sent throngs of therapists online. I received questions almost daily about Teletherapy and how therapists should market their online services to survive the transition to working from home.

Many of those same therapists frantically threw their savings at Ads and then watched their savings evaporate like a puddle on a sunny summer day.

Problems began when therapists relied on Google’s Smart Campaigns. A survey found that 77% of marketers found that regular campaigns are far more effective than Smart Campaigns—and I can agree from personal experience.

Why? I’ve talked about the proper way to create Ads at length elsewhere, but to summarize: Smart Campaigns don’t give therapists the control they need to make their Ads effective. They create the illusion that something complex can be streamlined simply. Ads must be created the old-fashioned way—manually—to be effective.

I’m not sure Google is being malicious. But I also know that 96% of Google’s revenue comes from advertising so it’s no wonder they push Smart Campaigns onto small businesses. It’s in their profits’ best interest to get everyone on board. Maybe one day whatever algorithms and AI Google’s Smart Campaigns are built around will be effective, but that day is not today, and is likely far into the future.

Google Ads Can be Powerful When Done Right

Used properly Ads are a powerful tool for private practices to jumpstart to become visible but they are rarely an effective long term strategy by themselves. To make them work therapists need:

  • Specialty Pages (on their website)
  • Negative Keywords
  • To fine-tune their campaign

Ads require effort, vigilance, experience. But many therapists don’t develop a strategy beyond Ads because Ads offer immediate gratification—until they don’t.

Admittedly, one thing the Bloomberg article does get right is that Google Ads is becoming prohibitively expensive for many small businesses. There’s more competition than ever for keywords.

Which is why small businesses in other industries (think shoes, games, furniture, etc.) have abandoned Google in favor of Facebook advertising. But Facebook advertising is effective for some types of businesses and not others (people tend not to look for “therapists near me” on Facebook). Therapists and private practices are stuck with Google’s monopoly on search and Ads.

For Ads to be worth the money therapists have to recognize that using Google Ads is a means to an end, not an end unto itself. And that end is an overall digital marketing strategy.

Organic Rankings Are More Important Than Ever

The marketer interviewed in the Bloomberg article said that companies shouldn’t bother tweaking their organic rankings—that organic doesn’t matter anymore compared to Ads. They’re bafflingly wrong. Their sweeping statement betrays a lack of expertise in the SEO (Search Engine Optimization) space. Whether or not an Ad is more effective than organic search is a complex question that must consider a number of variables:

  • whether a keyword used in the search is local or national,
  • any particular link’s position on organic search,
  • the intention of the searcher,
  • whether or not the search includes buyer keywords,
  • whether the search is done on mobile or desktop,
  • The geographical location of a searcher, etc.

The answer to each of the above will determine whether an Ad or organic result grabs a searcher’s attention. And those answers mix in a number of ways so that there is no clear cut notion of whether organic or paid matters more. The truth is that it’s neither.

(Also the idea that search results can be “stacked with ads” is a bit silly. Google only shows up to 4 ads above organic results and an additional 4 below organic results.)

The point is that the generalization “Only paid results matter” is hogwash.

Here’s some stats to dismantle the notion that Ads are the end-all-be-all that some marketers (mainly PPC marketers) proclaim they are:

Ads tend to dominate search results when they answer search queries that orbit immediate gratification: What shoes should I buy? Where can I get ramen today? What cleaner will finally remove spaghetti sauce stains from my electric oven top?

They’re not as effective for search queries revolving around long-term care or questions where searchers are comparing and contrasting various results—such as therapists.

Large Companies Don’t Dominate Organic or GMB

Google’s last Core Update shook up the organic rankings quite a bit. Many companies that traditionally owned local keywords, such as Psychology Today, were either bumped off the first page or lost a number of positions. (These changes in results are dependent on what local keyword is searched.)

That means local small businesses and therapists can compete against large companies in organic search—if they take steps to rank well organically. Google may have a monopoly on Ads but other companies don’t necessarily monopolize search.

Another aspect of the last core update was Google’s increasing emphasis on Google My Business listings. 

But to rank well on GMB, therapists have to not only optimize their listing but also their website—in the same way that to optimize Ads therapists need to optimize their website at least basic SEO.

What that means is that even if organic listings were completely irrelevant, therapists would still need to strategically develop and maintain their website as if they were seeking organic rankings. It’s the only way to make Ads and GMB effective.

BUT, the idea that organic is irrelevant is, again, absurd. Organic still accounts for a large portion of traffic that lands on therapy websites. Therapists who are hoodwinked into thinking all they need are Ads will never connect with potential clients.

Google is a Monopoly that Therapists (and anyone else) Can Work With

Culturally, we answer people’s questions by saying, “Just Google it,” and whenever a company has become a verb they’re almost too big to fail.

Google is being sued by multiple companies and the Justice Department and is the subject of multiple antitrust lawsuits, but none of the aforementioned indicates that Google’s control of search is going to be shaken. So therapists and private practices have to learn to live with Google. And they can.

Google Ads is one part of a much larger digital marketing strategy that includes SEO, GMB, and even social media marketing. One piece can’t stand alone. They all have to work together for therapists and private practices to thrive in the digital space and attract the potential clients they can help best.

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